Guilt is one of the common reactions nearly all women experience after a pregnancy loss. Whether your loss was so early you didn’t even know you were pregnant or you were only days from your due date, it’s hard not to wonder if you did anything wrong and what you could have done to prevent it.

The hard truth is, there was most likely nothing you could have done. In most cases, there was nothing anyone could have done to prevent your miscarriage or stillbirth. This site has many articles on the causes of pregnancy loss, including the few modifiable risk factors, such as smoking and alcohol use.

However, apart from cases where the direct cause is certain - such as an identifiable chromosome abnormality or a placental abruption - all those articles are talking about the same thing: risk factors (those conditions or situations that are associated with miscarriage or stillbirth). None of the risk factors is known to cause miscarriage 100% of the time. Even with a drug like cocaine, which is known to cause placental abruption, there are women who use cocaine who do not have miscarriages. The fact is most miscarriages and stillbirths occur in women who have no modifiable risk factors.

So why do you feel so guilty when you most likely know there was nothing you did to cause your loss or could have done differently to prevent it?

What Is Guilt?

In psychology, guilt is viewed as an emotion that stems from doing - or believing we have done - something wrong when we had the chance to do the right thing. Speaking sociologically, guilt serves the purpose of helping us have empathy for others. If we believe we have the chance to alleviate another person's pain or suffering, then we believe we should do whatever is needed to accomplish that goal. If we choose not to, the result is guilt.

Believe it or not, guilt and self-blame can be healthy, and they have their place in our emotional spectrum. For example, if you insult someone or skip out on your exercise routine, the feelings of guilt that follow are a reminder to do what is best. Whether it means making amends with the other person or sticking with your health-conscious habits, guilt can serve a purpose.

However, there are plenty of occasions when we feel guilty without the power to change our actions or behavior. That’s when guilt can become overwhelming and is no longer useful as an internal reminder. It’s an unhealthy guilt. An example of this might be when you watch a commercial for a charity to help feed poor children. Although you can do your part with a donation, realistically you don’t have the resources to end hunger on your own. Feeling guilty about your limited resources won’t change that.

In the case of a miscarriage, guilt most likely results from feelings of helplessness. We wish there was some warning for what was about to happen, some chance to intervene. It’s very difficult for people to see something as inevitable, especially with modern medicine at our disposal. As a result, we tend to look for anything we could have done differently, and feel guilty that we didn’t do it. Even knowing there was nothing you or your doctor could have done to change the outcome may not eliminate the feeling that you should have done more.

How Do You Deal with Feelings of Guilt?

There is no simple way of getting rid of guilty feelings or to stop blaming yourself, but there are some techniques you can try to alleviate those feelings.

•Make a change. If you have any concerns that your lifestyle choices may have played a role in your loss, you have the opportunity, and the power, to make changes in your life. If you’ve already decided to have more children, this is a good opportunity to make healthier choices for yourself. Quit smoking, eliminate alcohol, use stress reduction techniques, get regular medical care and follow your doctors’ instructions, especially if you have a chronic medical condition like high blood pressure or diabetes.

•Acknowledge your feelings. Whether or not you had an impact on your pregnancy loss, you can recognize your feelings of self-blame. Seeing your feelings as feelings - and not an indication of your actual guilt - can be the first step in letting go of the unhelpful emotions. Maybe it would help if you express your regret to your baby. A private, focused conversation, spoken aloud or to yourself, or a letter of apology addressed to your baby may help relieve some of your feelings.

•Ask for forgiveness. In all likelihood, no one blames you for your pregnancy loss. That doesn’t mean you can’t express your feelings of guilt to someone in your life and ask for forgiveness. You might be surprised by how relieved you feel if you tell your spouse or partner you’ve been blaming yourself and want their forgiveness. If you are religious, speak to your religious leader. Whether or not your faith has a formalized confession, your religious leader will most likely welcome your thoughts and help you seek forgiveness.

•Help someone else. It’s too late to change your own pregnancy outcome, but working to help others from experiencing the same grief can help alleviate feelings of guilt. Donate to a research organization dedicated to reducing miscarriage and stillbirth. Volunteer to speak about your experiences at a support group. Do work at your hospital's neonatal intensive care unit. Help out at a low-income prenatal clinic, so more women have access to the prenatal care they need for a healthy pregnancy.
Feelings of guilt are a normal part of the emotional response to pregnancy loss. Recognizing that you were most likely powerless to prevent your miscarriage or stillbirth is a difficult but important step in relieving your guilt. You may never completely eliminate those nagging feelings of "what if…" and "if I only…" But by following some of the above suggestions you may be able to channel your self-blaming tendencies into something positive.